Hypochondria
is a belief that real or imagined physical symptoms are signs
of a serious illness, despite medical reassurance and other
evidence to the contrary.

Causes,
incidence, and risk factors
A person suffering from hypochondria is preoccupied with physical
health and has an unrealistic fear of serious disease well
out of proportion to the actual risk. There is no specific
cause of hypochondria, and it occurs in men and women with
equal frequency.

Symptoms
*preoccupation with fear of illness
*persistent fear of having a serious illnesses despite medical
reassurance
*misinterpretation of symptoms
*symptoms that may shift and change
*symptoms that may be vague or specific
*no apparent physical disorder that can account for symptoms
*disturbance lasting for at least 6 months (24 weeks)
The affected person may recognise that the fear of having
a serious disease may be excessive, unreasonable or unfounded.

Signs
and tests
A physical examination should be performed to rule out an
underlying organic disease. A psychological evaluation should
be performed to rule out other related disorders.

Treatment
A supportive relationship with a health care provider is the
mainstay of treatment. There should be one primary provider
to avoid unnecessary diagnostic tests and procedures. The
health care provider should inform the person that no organic
disease is present, but that continued medical follow-up will
help control the symptoms. The person with hypochondria feels
real distress, so the symptoms should not be denied or challenged
by others.

Expectations
(prognosis)
Generally, the disorder is chronic (lasts for a long time)
unless the psychological factors or any related underlying
mood disorder are addressed.

Complications
*There is a possibility that a real disease may be overlooked
in people with hypochondria because their previous complaints
were unfounded.
* Complications may result from invasive testing and multiple
evaluations looking for the cause of symptoms.
* Dependence on pain relievers or sedatives may develop.
*Frequent appointments with health care providers are typical,
and time from work may be lost.

SELF-TEST
FOR HYPOCHONDRIA

Below
is a list of questions about your health. For each one,
please circle the number indicating how much this is true
for you. A high score is an indication that you could
profit from talking this over with your doctor.
1 = Not at all
2 = A little bit
3 = Moderately
4 = Quite a bit
5 = A great deal
1: Do you worry a lot about your health?
12345
2: Do you think there is something seriously wrong with
your body?
12345
3: Is it hard for you to forget about yourself and think
about all sorts of other things?
12345
4: If you feel ill and someone tells you that you are
looking better, do you become annoyed?
12345
5: Do you find that you are often aware of various things
happening in your body?
1 2 3 4 5
6: Are you bothered by many aches and pains?
1 2 3 4 5
7: Are you afraid of illness?
1 2 3 4 5
8: Do you worry about your health more than most people?
1 2 3 4 5
9: Do you get the feeling that people are not taking your
illnesses seriously enough?
1 2 3 4 5
10: Is it hard for you to believe the doctor when he/she
tells you there is nothing for you to worry about?
1 2 3 4 5
11: Do you often worry about the possibility that you
have a serious illness?
1 2 3 4 5
12: If a disease is brought to your attention (through
the radio, TV, newspapers, or someone you know), do you
worry about getting it yourself?
1 2 3 4 5
13: Do you find that you are bothered by may different
symptoms?
1 2 3 4 5
14: Do you often have the symptoms of a very serious disease?
1 2 3 4 5
The higher the score the more hypochondriacal you are
likely to be. There is no set cutoff score, but healthy
people without health anxiety generally have a score of
21 +/- 7 (14 to 28). Patients with hypochondria are found
to have a score of 44 +/- 11 (32 to 55). These numbers
are merely indications to help you find out if you have
hypochondria. If your score is high we suggest you talk
to your doctor about it - may be he can advice you where
to find help.
Notice that if you are depressed you also might get a
high score, and your hypochondriacal ideas might be secondary
to your depression. The same is true if you have a specific
or general anxiety disorder. In both instances you can
talk to your doctor about this.